Endo Flashcards
Serum Na – Low UO - Normal or Low Urine sodium – High Intravascular vol status – Normal or high Vasopressin Level – High
SIADH
Serum Na – Low UO - High Urine sodium – Very High Intravascular vol status – Low Vasopressin Level – Low
Cerebral Salt wasting
Serum Na – High UO - High Urine sodium – Low Intravascular vol status – Low Vasopressin Level – Low
Central DI
1 in 500-1,000 live male births; manifest as tall stature, learning disabilities, gynecomastia, dec U:L segment ratio; Boys: hypotonia, clinodactyly and hypertelorism; Testes small → indertility
(Klinefelter syndrome XXY syndrome)
Tall stature, severe acne in adolescence, inc incidence of learning disability; behavioral problems (impulsivity)
XYY syndrome
Thelarche
10-11 yr old
Pubarche
6-12 mo later
Menarche
2-2.5yr → 6 yr
Thinning of the scrotum
11-12 yr old
Axillary hair
mid-puberty
Treatment of D.I in neonates and young infants
Fluid therapy
Treatment of D.I in older Children
DDAVP (dosage: 25 – 300ug every 8-12 hr)
Polyuria and polydipsia with vasopressin deficiency
Central D.I
Polyuria and polydipsia with vasopressin insensitivity at the level of the kidney
Nephrogenic D.I
MC pituitary tumors in adolescent
Prolactin – secreting pituitary adenoma / Prolactinoma
Manifest as headache, primary or secondary amenorrhea, Galactorrhea
Prolactin – secreting pituitary adenoma / Prolactinoma
Prolactin level of mild Prolactin – secreting pituitary adenoma
40-50 ng/ml
Prolactin level of mild Prolactin – secreting pituitary adenoma
10,000-15,000 ng/ml
Treatment for prolactinoma
Cabergoline
Definitive diagnosis of GH deficiency
absent or low levels of GH in response to stimulation
Definitive diagnosis of GH deficiency traditionally requires
Demonstration of absent or low levels of GH in response to stimulation
DI manifest manifests clinically with
Polyuria and polydipsia and can result from either vasopressin deficiency or vasopressin insensitivity at the level of the kidney
To differentiate central from nephrogenic DI, what test is needed
Water deprivation test
Hyponatremia, inappropriately concentrated urine (>100 mOsm/kg), normal or slightly elevated plasma volume, normal to high urine sodium and low serum uric acid
SIADH
Treatment of CSW
Consist of restoring intravascular volume with sodium chloride and water
MC adenoma during childhood
Prolactinoma
Central precocious puberty
breast development before the age of 8 yr in females and by the onset of testicular development before the age of 9 yr in males
Most sensitive test for primary thyroid dysfunction
serum TSH
Most cases of congenital hypothyroidism are caused by
Thyroid dysgenesis
Most important method for identifying infants with congenital hypothyroidism
NBS
Usually first clinical manifestation of acquired hypothyroidism
Slowing growth
Typically preceded by a respiratory infection of pharyngitis, and the left lobe is more often affected. The infection may be caused by gram positive or gram negative organism, and abscess formation can occur
Acute infectious thyroiditis
Most serious consequence of iodine deficiency and occurs only in geographic association with endemic goiter
Cretinism
MC cause of endemic goiter worldwide
Iodine deficiency
First line anti thyroid drug for children with Graves Disease
Methimazole
Management goal of thyroid storm in adolescent
inhibition of thyroid hormone formation, sympathetic blockade and glucocorticoid therapy
Principal regulators of calcium homeostasis
PTH and Vitamin D
Acquired primary adrenal insufficiency is termed
Addison Disease
More than 90% of CAH are caused by
21-hydroxylase deficiency
The result of abnormally high blood levels of cortisol or other glucocorticoids. This can be iatrogenic or the result of endogenous cortisol secretion, a result of either an adrenal tumor or of hypersecretion of corticotropin by the pituitary or by a tumor
Cushing syndrome
Hypertension in children is more often sustained rather than paroxysmal. When there are paroxysms of hypertension, the attacks are usually infrequent at first, but become more frequent and eventually give way to continuous hypertensive state. Between attacks of hypertension, the patient may be free of symptoms. During attacks, the patient complains of headache, palpitations, abdominal pain, dizziness, pallor nausea and sweating
Pheochromocytoma
MC endocrine-metabolic disorder of childhood and adolescence, with important consequences for physical and emotional development
Hyperthyroidism
Treatment for T1DM – Insulin
• Classification of DKA: Co2 = 10 – 15mEq/L venous, pH (venous) – 7.15 – 7.25 with Kussmaul respiration
Moderate
Most important lifestyle factor association with development of T2DM
Obesity
